International omicron doubling

well welcome to today's talk friday the 10th of december and i want to do an international update on what's going on in the omicron situation now i think what we need to realize is that where south africa is now the united kingdom will probably be in two or three weeks maybe four weeks and the united states will be a few weeks after that this is kind of the progression of the spread over omicron so we need to look at what's going on in south africa to find out what's going to be happening to us pretty soon so let's go straight on to the orientation slides and here we do see it has to be said quite a steep increase in the amount of hospitalizations in south africa so the blue is uh public and the green is private so it's the total number we need to look at so we are indeed seeing an increase in hospitalizations in south africa now as far as we can tell the percentage of hospitalizations is not that high it's the sheer number of people with infections that seems to be the issue here now when we look at the ward situation in south africa as we have been doing so we see that there's a 5 300 earth people in hospital and 404 of those are in intensive care and bear in mind this is for the whole country a population of 40 million high care 419 normal ward care 4 five hundred and twenty one so patients actually in hospital has to be said fairly fairly modest numbers at the moment and then when we look at the degree of care that those patients are requiring so um they're the patients in hospital that is patients in uh intensive care and this is patients that are currently oxygenated in in high care so for the whole country 734 patients oxygenated so we're not seeing the massive oxygen demand in the care in south africa that we saw in the other previous wave so it's looking like patients are not as ill which is very very encouraging now just a few more orientation screens before we get down to some detail confirm new cases now um this is um slovenia here we have large cases now we don't have good genomic information on that we believe this is still delta but but we don't really know belgium netherlands switzerland denmark island norway france united kingdom germany united states canada india japan in that order japan still following up at the at the bottom there we do know there's quite a little bit of omicron in um denmark we do know there's quite a bit in uh norway but uh carrying on with the orientation now here we see that the actual omicron in red here is just way behind this data is way out of date for example we know that in denmark there's a lot of omicron so our world in data simply not keeping up but we will carry on seeing an increasing uh redness of that graphic as we keep an eye on the omicron over the next uh days and weeks indeed a number of patients in hospital slovakia part of the old czechoslovakia of course a lot of patients in hospital there um and indeed belgium hospital patients growing up quite significantly then switzerland united states france netherlands united kingdom island denmark norway canada and we do notice that norway and denmark do have quite large numbers of omicron patients or can or confirm cases but so far relatively low hospitalizations so that continues to be encouraging now this is the stringency index i haven't put this slide on before but it's quite interesting this is just sort of a this is a stringency index is a is a composite to measure based on nine response indicators including school closures workplace closures travel ban so it's basically how much of a a restrictive lockdown there is at the moment and this is the order uh germany uh with the most restrictions then going on to canada france slovakia netherlands you can see that for yourself so that's quite interesting norway with very low uh restrictions there um so i thought that was just an interesting one to put in that this is the way that countries are responding to the current pandemic newly confirmed cases per million people south africa going up dramatically and we will be seeing this sort of increase in cases in the united kingdom and the united states and possibly canada because this is leading the way so omicron charges being led by south africa followed by the united kingdom and canada with the united states where it's in about half the states now but is still in its process of spreading around in the united states hospitalizations in south africa as we've seen have gone up quite sharply but this is because so many people we believe it's because so many people have the infection at the moment so that's a bit of orientation now going on to a bit of detail michelle wilinski sensitive visitors control of course the disease is mild in almost all of the cases seen so far in the united states which is good having said that i think that's based on about 43 cases that the states have identified now of course there's way more cases than this in the states but the genomic sequencing is pretty pathetic so um that's all they've managed to definitely confirm so far but we can assume that we could put a naught on the end of that i think quite easily 75 of cases are vaccinated so we see that vaccinated people are becoming infected and testing positive with omicron this is repeated all over the world now scotland is expecting a tsunami of omicron families in scotland to self-isolate for 10 days if one member tests positive regardless of their vaccination status and even if they initially get a negative test so this is sort of the political response in scotland and of course what this means if this is maintained as omicron increases in scotland scotland is basically going to completely shut down if this is maintained so it's hard to see how it can be really uk governments already working on a plan c parts of plan b came into force was it yesterday yeah yesterday i think was it the day before and uh plan c in other words the uk government's comparing preparing for for a worse case scenario now uk health security agency this is their latest uh twittering uh about an hour ago 1265 confirmed cases we can easily put a naught on the end of that i'm quite sure about that so there's 12 20 000 cases in the uk at the moment something like that now this is from the uk health security agency used to be public health england omicron is displaying a significant growth advantage to delta so it's our competing delta now people often ask me do you think that um we're going to end up with delta and omicron and i think what we've seen in south africa is that the omicron has replaced the delta so i think it's likely it's going to replace it because it is so much more transmissible people also often ask can you become infected with two strains of the virus at the same time for example could you get omicron and delta at the same time absolutely you could and what happens then we're not really sure but certainly you could and indeed perhaps the reason we have the omicron variant is because someone got the delta infection and they had a um a coronavirus common cold as well and the two viruses shared their genetic material from co-infection and we know that if people get um covered and uh influenza at the same time that's associated with a worse prognosis so certainly you can have as many viruses as you as you're exposed to at the same time it's not that you you only have one at a time multiple co-infections are certainly feasible uh likely to outcompete delta and become the dominant variant yes i mean we've been saying this for about a week on this channel of course but it's good to see that um the uk health security agency are now confirming this if the growth rate and doubling time continues at least 50 of covered 19 cases to be caused by omicron variant by mid-december which is only about well when is mid-december i suppose it's the uh it's only five days always and if you think about it so basically it's increasing uh massively so omicron 50 of cases pretty soon one million by by the end of december if one percent are hospitalized which is probably possible that would equal 10 000 people over the course of between now and christmas so over about a couple of weeks so i'm i'm optimistic about this now neil ferguson who's been written up in the guardian again today is saying up to 10 000 cases per day but he's been wrong so many times in the past i'm not even going to mention it this time so that's kind of what i'm expecting lower rates of hospitalization with omicron compared to delta this this is bad 10 000 people could be admitted to hospital but over a couple of weeks even though it's putting a strain on the health service that is manageable let's hope it's not worse than what the south africa data would tend to intimate which is what i'm basing that on although that is i can't say that's evidence-based it's not it's a bit of a guess but um we'll see how that pans out um omicron displays a reduction in protection offered by having had a previous infection or vaccination so immune escape after infection immune escape after vaccination in other words if you've been infected with sarcoma virus ii or you've been vaccinated you can still get omicron there's insufficient data to make any assessment of the protection against severe disease so how much vaccination is going to protect against severe disease they don't know although other other evidence does suggest that it could be quite significant protection against severe disease but this is this is this is just a uk health security agency kind of catching up or to assess the severity of illness caused by omicron well again the data now from south africa is becoming fairly convincing that this is less severe and we saw that was michelle willinski's view as well so i think the best thing you could say about the uk security agency here is they're being very conservative and not making too many claims further studies are underway of course now it's quite an interesting graph um basically this shows that um so this is the increase in in omicron here basically it shows that it was in now the the these are based on um this s gene drop out so they could this could have been through other causes i'm not sure omicron's been around this long but i suspect omicron could definitely have started about about here the cases would have started about there which takes us to about the 16th of november so it looks like omicron has been present in the uk from the 16th of november and of course the world health organization didn't tweak till the 26th and of course that means the travel bans were far too late and now we have ongoing community transmission of omicron of course um lots of other references there to follow the south africa situation i'll leave those in the uh in the description if you want to follow that on now scientific advisory group for emergencies sage now it's fair to say that this group as well has had a pretty mixed record considering this is supposed to be all the great experts in the country their prognostications have often been less than impressive but it's what we've got at the moment so it's what we'll go with hospital admissions from omicron should be expected to follow soon high confidence well this is true this is true so so we know that if this is if this is time here time going on there that as omicron cases uh start to increase hospitalizations will also follow with a delay the question is to what degree will they follow i'm hoping it's going to be kind of like that it's going to follow it in that this gap here is going to be sort of consistent-ish but i'm hopeful it's going to be at low numbers um but the high confidence that it will it will increase soon and the south africa data does show us that hospitalizations increase soon uh increase after omicron has spread but with lower oxygen requirements in the south african situation though there remain some important uncertainties well of course they have to hedge their bets don't they early verbal reports indicate that hospitalizations due to romicron are now increasing in south africa well it's not verbal reports we've just seen on the graphics why don't they look at the uh the south africa data then they wouldn't be saying verbal reports it's on the south africa official data really makes you wonder sometimes um the doubling time for the new omicron infection is currently around three days in england so if i'm right there's about twenty thousand cases now then of course that means there's going to be forty thousand cases in three days time eighty 000 cases three days after that you can work it out for yourself 160 through whatever it is you can see it's not going to take long to get to a million can't you it really is going to increase exponentially it's unlikely to be any slower than a five-day doubling time so so basically they're saying a three to five day doubling time for the number of cases and if that carries on clearly clearly it's going to displace delta household studies show higher secondary attack rates in other words if someone in the household gets it other people in the household are likely to get it and they're highly confident of that of course it's a highly transmissible variant so why is it so transmissible combination of transmissibility it seems to hang around in the air for longer so if someone breathes it out then it seems to it seems to stick around in the air for a longer period of time these uh micro droplets this aerosolization in the air seems to hang around for longer is there a higher viral load that people are putting more virus out we don't know probably is it that each viral particle has a higher affinity for the human receptor it could be that as well but anyway sage the yeah this is sage have said it's increased transmissibility pretty obvious but they've said it anyway and immune escape so what they mean here is the people that have had it before and the people have been vaccinated are no longer protected therefore in other words the majority of the population is vulnerable to infection i think we're all going to get this in the next few weeks because of the immune escape i've been vaccinated but i still expect to be infected with omicron people that have had um covered disease sars coronavirus 2 infection i still expect them to get infected with omicron hopefully virtually or with minimal or no symptoms but um it's it's as if the whole population is now vulnerable and naive all over again although we do believe there's good early evidence that protection from severe disease and hospitalization is going to be there as a result of the immunity we already have but the infection is going to be everywhere that means everyone's going to be infected that's potentially a good thing because it means that everyone's infected therefore everyone will develop a level of immunity because the infection will generate an immune response specific to the omicron variant and if you have an immune response to the omicron variant i would expect a degree of cross immunity to the other um corona viruses as well how much cross immunity of course we don't know but i would expect there to be some so i would spec some i would expect someone who's infected with omicron to enjoy some protection from future variants of sars coronavirus 2 certainly in terms of protection against severe disease hospitalization and death we don't know for sure but i would be very surprised if that's not the case some early indications from south africa suggest less severe disease in those hospitalized correct a modest reduction in severity would not avert high numbers of hospitalizations if growth rates remain high so instead of having about four percent of patients in hospital even if we just add 0.4 percent of patients in hospital then if a few million people get it all at the same time as we said that's comes out to large numbers my estimate there was about one percent by christmas which would be ten thousand ten thousand potential hospitalizations uh which is is perhaps slightly less than we're getting now in that time period or around about what we're getting now even though the numbers are increasing dramatically that's probably what's going to happen sage is saying a thousand per day by the end of the month um then they're saying the peak is likely to be higher one to two thousand omicron hospitals per day without interventions that depends how much uh closing down we do to prevent the spread if we have a plan c of course it's going to be less than that and instead of doing the case is doing this and getting it all over within a few weeks we can as boris johnson said flatten the sombrero and it'll be more like that but if people aren't getting hospitalized the herd immunity will develop if we have large-scale exposure in a short period of time i believe uh for is to be below this level there would be where they would if it's going to be low this level that only need to be a small degree of immune escape and very high protection so we're hoping for a small degree of immune escape we're hoping from high protection from boosters but we don't know um so that they're saying it could easily be um well they're expecting more to 2000 but if if it is going to be below that these these criteria would have to be met uh with very rapid doubling times a large wave could occur leading to synchronous absence from work well in the scottish case where everyone has to self-isolate that's certainly going to be the case the country will close down in the uk you can get away with in england rather you can get away with daily testing scotland um you need to isolate um with lags of the order of two weeks or more of course before people get sick and doubling times in the order of three days it's likely that once hospitalizations begin to increase um there's going to be a similar rate of increase just with the delay and here is an example four doublings that's a 16-fold increase of course um or more could um already be in the system so if there's going to be 16 times more cases already baked into the system and the hospitalizations were the same as they are now which we believe they're not fortunately then there'd be 16 times more hospitalizations but of course we don't believe that is the case a great role for airborne transmission this is very airborne compared to previous variants it looks like and last last point i want to make here uh ventilation well-fitting masks distancing or reduced density of people in indoor environments may be even more protective because of the airborne nature so that's the update for today that's what i wanted to talk about today um governments and these official agencies are correctly being more conservative and um they have to prepare for the worst so i understand that um but but i'm hoping for much better based on the south africa data and indeed based on that data we looked at yesterday from norway now i was talking to him a technician that we're finished now there was talking a technician and he said the downloads of the books have been well over a hundred thousand so that's if everyone reads them i'll be delighted so remember that the pathophysiology book on disease the physiology book on uh normal body functioning available for free download um so well over a hundred thousand so that's great i feel justified for having spent three years each writing them now so so that's good now um slight correction now uh interesting so this is a bit of a scientific point but an interesting one now we did quote professor frondland norwegian institute of public health it might be that it is now replicated and mutated so many times that this is the optimal position from the new viruses point of view to spread widely and not kill the hosts so this is what we quoted professor forland as saying um that's what we've seen with other diseases beforehand and of course uh then it gets into more of an endemic phase and yesterday i think i did agree with this that uh sometimes diseases do become milder um so that the uh the virus can spread but michael's picked me up on this and it turns out that technically i'm well i'm not technically i i i was wrong so michael says this in your talk about the oslo party you embraced another wrong reference that many people like to believe so good the claim that viruses tend to become less lethal because not killing their host keeps the viruses uh in the host alive too and enables the host to keep infecting makes the virus more contagious so this is kind of what we were what we were saying so um this is what we were saying that if the virus doesn't uh kill the host the virus will stay alive for longer and there'll be more transmission therefore it's in the viruses evolutionary interest to um not kill their host therefore it's in the the virus should evolve to become weaker but this is not correct as michael points out and he's right when we think about it this claim may be contested even in the general case okay we won't argue about that one um but it's certainly wrong for sars coronavirus too since as you pointed out many times and of course you're quite correct michael the death of the victim almost always happens after he is no longer infectious so by this time the virus is cleared off the virus has already reproduced and gone off to effect someone else so whether the individual goes on to die when the virus is finished with them is irrelevant to the virus it won't bring about a selection pressure so so michael's quite right that um that people that the virus is not the size coronavirus 2 particularly has not got this selection pressure to become less virulent and less pathogenic because by the time it does kill people the virus doesn't care it's already moved on the virus is only reproducing in the the infectious stage for the first week or so or even less about in most people about the first week and therefore if the patient goes on to die after that the virus doesn't care which is absolutely true the death of the victim almost happens after he is no longer infectious and this means that prolonging the life of the victim does not prolong the period of infectivity so there you go um there's no evolutionary pressure in that sense for the virus not to kill their host therefore the idea that natural selection would select for a virus which does not kill their host is wrong because to the virus whether it survives or not the death of the host is irrelevant we tend to say that the virus thinks this or the virus wants that thing or the other and of course of course that's not what we mean what we mean is this is the the outcoming of the selection pressures both positively and negatively that will affect the virus and therefore affect its reproduction so thanks for that michael um bad news though it means that there's no evolutionary selection pressure for the virus in the case of sars coronavirus 2 to evolve to cause milder disease because by the time someone dies the virus has already moved on so there you go always good to be corrected you are my peer reviewers so thank you for that thank you michael and thank you for watching

Channel: Dr. John Campbell

Views: 482,029

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: Ss1LSwjtrhA

Length: 25min 16sec (1516 seconds)

Published: Fri Dec 10 2021

Reddit Comments

[u/Biomedical_trader]

The short explanation is that COVID has no incentive to play nice and cause mild disease. If Omicron is allowed to spread, that could create a more dangerous variant.

[u/Logical_North4426]

Right now, the omicron variant, is 4 times more transmisible, but with milder symptoms. Is the natural evolution of this virus. It needs a host, and if the virus kills more people, it won’t be able to replicate as fast, and won’t be able to jump, from host to host. So the virus is sacrificing killer symptoms, for his ability to stay alive.
If you start to read about the Spanish flue (1918), it killed 50,000,000 people, aprox, but it disappear, 2 years and a half, after the first report case. History is bound to repeat itself. My calculation tells me that by October next year, this is going to disappear or it’s going to be so normal, that people won’t care enough. Like the flue, part of our life. That’s why we need our results ASAP.

[u/Minocko]

Its funny that you keep posting Dr. John Campbell. I have followed him for some time now and if you look at some of his older videos - his take on the Vaccine is quite interesting. I have mentioned multiple times in this Sub that there is a concern with the vaccine and mandating them. Look at this very popular video "Natural versus vaccine immunity".. I think you will see where I'm coming from.